Warren Whistleblowers Win Medicare Fraud Case

Peter Salvatori and Sara Iveson will share in $1.2 million dollars for their role in a Medicare fraud case against Warren Hospital of Phillipsburg, New Jersey. This is part of a of a 7.5 million dollar settlement that the hospital agreed to after charges were brought under the Federal False Claims Act.

According to the U.S. Department of Justice, the hospital inflated Medicare charges to receive payments it wasn’t entitled to between January 1998 and August 2003. The allegations related to Medicare’s costliest treatments. Patients under such care are called ‘outliers’ because their needs stretch beyond typical parameters of the program.

Indicators have suggested that this is just another example of rampant Medicare Fraud. From The Morning Call:

Whistle-blowers have tipped off the government to $1.3 billion worth of fraud cases in the last year, largely at hospitals or other health care providers, the Justice Department said.

The department recovered $3.1 billion from individuals and companies during the fiscal year that ended Sept. 30, 2006.
In return, whistle-blowers were paid $190 million for alerting the government to the fraud.

For the basics on prevention and detection check out the US Department of Health’s Medicare Fraud page.